Select a medication above to begin.
Tecartus
brexucabtagene autoleucel
Black Box Warnings .
Appropriate Use
restricted distribution program (YESCARTA and TECARTUS REMS) due to cytokine release syndrome (CRS) and neurological toxicity risk; admin. only at certified healthcare facility w/ trained healthcare providers to manage CRS and neurological toxicities; certified healthcare facility must have on-site, immediate access to tocilizumab, and a minimum of 2 doses of tocilizumab for each pt w/in 2h after tx if needed; 1-844-454-5483 or www.YescartaTecartusREMS.com for more info
Cytokine Release Syndrome
incl. life-threatening rxn, occurred; do not admin. if active infection or inflammatory disorders; treat severe or life-threatening CRS w/ tocilizumab +/- corticosteroids; monitor pts daily for at least 7 days post-infusion at certified healthcare facility, then monitor s/sx x4wk after tx w/in proximity of certified healthcare facility; counsel pts on s/sx and to seek immediate medical attention if they occur at any time
Neurological Toxicities
incl. life-threatening rxn, occurred, incl. concurrently w/ CRS or after CRS resolution; provide supportive care and/or corticosteroids as needed; monitor pts daily for at least 7 days post-infusion at certified healthcare facility, then monitor s/sx x4wk after tx w/in proximity of certified healthcare facility
Secondary Hematological Malignancies
incl. T-cell malignancies, have occurred; monitor life-long; contact Kite at 1-844-454-5483 to report malignancy occurrence and obtain instructions on pt sample collection
Adult Dosing .
Dosage forms: INJ
Restricted Distribution in US
- [1-844-454-5483 or www.YescartaTecartusREMS.com for more info]
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, prophylactic antimicrobials, and dosing
mantle cell lymphoma, relapsed or refractory
- [2 x10^6 chimeric antigen receptor (CAR)-positive viable T-cells/kg/dose IV x1]
- Start: 2 days after completing lymphodepleting combo chemo regimen cyclophosphamide + fludarabine; Max: 2 x10^8 CAR-positive viable T-cells/total dose
B-cell precursor ALL, relapsed or refractory
- [1 x10^6 chimeric antigen receptor (CAR)-positive viable T-cells/kg/dose IV x1]
- Start: 1 day after completing lymphodepleting combo chemo regimen cyclophosphamide + fludarabine; Max: 1 x10^8 CAR-positive viable T-cells/total dose
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy
- infection, active
- inflammatory disorder
- avoid: blood donation indefinitely
- avoid: organ donation indefinitely
- avoid: tissue donation indefinitely
- avoid: cell donation indefinitely
- caution: hypersensitivity to DMSO
- caution: hypersensitivity to gentamicin
- caution: pts of childbearing potential
- caution: HBV carriers
Drug Interactions .
Overview
brexucabtagene autoleucel
CAR T cell immunotherapy
- immunomodulatory effects (other)
- immunosuppressive oncologic agent
- lowers seizure threshold
- myelosuppressive oncologic agent
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- abrocitinib
- aldesleukin
- amifampridine
- anifrolumab
- anti-thymocyte globulin
- arsenic trioxide
- azathioprine
- basiliximab
- belatacept
- betamethasone
- budesonide
- budesonide rectal
- chloramphenicol
- cladribine oral
- cortisone
- cyclosporine
- deferiprone
- deflazacort
- deuruxolitinib
- dexamethasone
- dexrazoxane
- etrasimod
- everolimus
- fexinidazole
- fludrocortisone
- ganciclovir
- hydrocortisone
- iohexol
- lymphocyte immune globulin, anti-thymocyte globulin
- methylprednisolone
- mycophenolate mofetil
- mycophenolic acid
- natalizumab
- palifermin
- penicillamine
- pimecrolimus topical
- prednisolone
- prednisone
- primaquine
- rabies vaccine
- radium Ra 223 dichloride
- ritlecitinib
- ropeginterferon alfa-2b
- ruxolitinib topical
- sirolimus
- tacrolimus
- triamcinolone
- valganciclovir
- vamorolone
- voclosporin
Monitor/Modify Tx
- acetazolamide
- albendazole
- alemtuzumab
- aliskiren
- allopurinol
- amikacin
- amiloride
- anthrax vaccine
- asenapine
- atidarsagene autotemcel
- auranofin
- balsalazide
- baricitinib
- benznidazole
- betibeglogene autotemcel
- brimonidine ophthalmic
- bromocriptine
- bumetanide
- bupropion
- butorphanol
- candesartan cilexetil
- captopril
- carboplatin
- chikungunya vaccine
- chlorpromazine
- cidofovir
- cinacalcet
- cisplatin
- clofarabine
- clomipramine
- clozapine
- colchicine
- corticotropin
- COVID-19 vaccine
- cyclophosphamide
- dapsone
- deferasirox
- desflurane
- desipramine
- dinutuximab
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- dipyridamole
- ebola vaccine, live
- efbemalenograstim alfa
- eflapegrastim (G-CSF)
- elivaldogene autotemcel
- enalapril
- enalaprilat
- entrectinib
- eplerenone
- epoprostenol
- ethacrynic acid
- ethanol
- exagamglogene autotemcel
- felodipine
- fenoldopam
- fenoprofen
- fentanyl
- filgrastim (G-CSF)
- flaxseed
- flucytosine
- fluphenazine
- foscarnet
- fostamatinib
- gentamicin
- givinostat
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydrocodone
- hydroxychloroquine
- hydroxyurea
- iloperidone
- iloprost inhaled
- imipramine
- indapamide
- influenza H5N1 vaccine
- influenza vaccine
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- iopamidol
- isoflurane
- isoproterenol
- isosorbide dinitrate
- isosorbide mononitrate
- isradipine
- Japanese encephalitis vaccine
- ketoprofen
- leflunomide
- linezolid
- lonafarnib
- lovotibeglogene autotemcel
- loxapine
- lumateperone
- magnesium sulfate
- mannitol
- meclofenamate
- mefenamic acid
- meningococcal vaccine
- meperidine
- mercaptopurine
- mesalamine
- mesalamine rectal
- methazolamide
- methohexital
- methotrexate
- metolazone
- mifepristone
- moexipril
- nabumetone
- nalbuphine
- neomycin
- niacin (vitamin B3)
- nimodipine
- olmesartan medoxomil
- olsalazine
- opium
- osilodrostat
- paromomycin
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- pentamidine
- pentazocine
- perindopril
- perphenazine
- phenoxybenzamine
- phentolamine
- pneumococcal vaccine
- poliovirus vaccine
- proguanil
- propofol
- protriptyline
- pyrimethamine
- ramipril
- remifentanil
- remimazolam
- respiratory syncytial virus vaccine
- ribavirin
- rifabutin
- rituximab
- rotigotine transdermal
- sacituzumab govitecan
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- silodosin
- smallpox/mpox vaccine, live
- stiripentol
- streptomycin
- succimer
- sufentanil
- sulfasalazine
- sulindac
- tafasitamab
- tagraxofusp
- tapentadol
- teplizumab
- teriflunomide
- thalidomide
- tick-borne encephalitis vaccine
- tobramycin
- tocilizumab
- tofacitinib
- tolmetin
- torsemide
- trandolapril
- triamterene
- trifluoperazine
- trimethoprim
- trimipramine
- typhoid vaccine
- upadacitinib
- valproic acid
- vardenafil
- venlafaxine
- vinblastine
- vincristine
- vinorelbine
- zidovudine
Caution Advised
- abatacept
- adalimumab
- anakinra
- avacopan
- beclomethasone inhaled
- beclomethasone nasal
- belimumab
- bimekizumab
- brivaracetam
- brodalumab
- budesonide inhaled
- budesonide nasal
- busulfan
- canakinumab
- cannabidiol
- carbamazepine
- cenobamate
- certolizumab pegol
- chlorambucil
- clobazam
- clobetasol ophthalmic
- clonazepam
- clorazepate
- crovalimab
- danicopan
- deucravacitinib
- dexamethasone ophthalmic
- diazepam
- difluprednate ophthalmic
- dimethyl fumarate
- diroximel fumarate
- dupilumab
- eculizumab
- efgartigimod alfa
- emapalumab
- eslicarbazepine acetate
- etanercept
- ethosuximide
- felbamate
- fenfluramine
- fingolimod
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosphenytoin
- gabapentin
- ganaxolone
- golimumab
- guselkumab
- hydrocortisone ophthalmic
- inebilizumab
- infliximab
- iptacopan
- ixekizumab
- lacosamide
- lamotrigine
- lebrikizumab
- levetiracetam
- lindane topical
- lorazepam
- loteprednol ophthalmic
- magnesium citrate
- methsuximide
- midazolam
- mirikizumab
- mitoxantrone
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- nadofaragene firadenovec intravesical
- nipocalimab
- ocrelizumab
- ofatumumab
- oxcarbazepine
- ozanimod
- pegcetacoplan
- perampanel
- phenobarbital
- phenytoin
- polyethylene glycol
- polyethylene glycol/electrolytes
- ponesimod
- pozelimab
- prednisolone ophthalmic
- pregabalin
- primidone
- promethazine
- ravulizumab
- rilonacept
- risankizumab
- rozanolixizumab
- rufinamide
- secukinumab
- siltuximab
- siponimod
- sodium picosulfate
- spesolimab
- sulfate bowel prep
- sutimlimab
- tezepelumab
- tiagabine
- tildrakizumab
- topiramate
- tralokinumab
- tramadol
- treosulfan
- tuberculin purified protein derivative
- ublituximab
- ustekinumab
- vedolizumab
- vigabatrin
- vilobelimab
- zilucoplan
- zonisamide
Adverse Reactions .
Serious Reactions
- cytokine release syndrome
- hypotension, severe
- fever
- hypoxia
- respiratory failure
- pulmonary edema
- pleural effusion
- acute kidney injury
- HTN
- arrhythmia
- seizures
- neurotoxicity, severe
- encephalopathy
- aphasia
- hypersensitivity rxn, severe
- anaphylaxis
- infection, serious
- febrile neutropenia
- HBV reactivation
- neutropenia, incl. prolonged
- thrombocytopenia, incl. prolonged
- anemia, incl. prolonged
- hypogammaglobulinemia, incl. prolonged
- lymphopenia
- macrophage activation syndrome
- hemophagocytic lymphohistiocytosis
- thrombosis
- secondary malignancy
- T-cell malignancy
- chimeric antigen receptor (CAR)-positive lymphoma
Common Reactions
- fever
- cytokine release syndrome
- hypotension
- encephalopathy
- fatigue
- tachycardia
- infection
- rigors
- hypoxia
- tremor
- cough
- thrombocytopenia, incl. prolonged
- musculoskeletal pain
- neutropenia, incl. prolonged
- nausea
- edema
- headache
- constipation
- diarrhea
- appetite decr.
- dyspnea
- rash
- insomnia
- pleural effusion
- aphasia
- dizziness
- delirium
- renal insufficiency
- HTN
- abdominal pain
- motor dysfxn
- thrombosis
- anemia, incl. prolonged
- oral pain
- hypogammaglobulinemia
- anxiety
- vomiting
- neuropathy
- coagulopathy
- bradycardia
- arrhythmia
- dysphagia
- xerostomia
- ataxia
- hemorrhage
- dehydration
- respiratory failure
- seizures
- pulmonary edema
- ICP incr.
- lymphopenia
- hypophosphatemia
- hypocalcemia
- infusion rxn
Safety/Monitoring .
Monitoring Parameters
screening for HBV, HCV, HIV before leukapheresis; pregnancy test at baseline; s/sx infection before and after infusion; CBC, IgG levels after infusion; s/sx cytokine release syndrome, neurological toxicities daily for at least 7 days post-infusion at certified healthcare facility, then x4wk after tx w/in proximity of certified healthcare facility
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use during pregnancy; no human or animal data available; possible risk of B-cell lymphocytopenia and hypogammaglobulinemia based on drug's mechanism of action
Individuals of Reproductive Potential
obtain negative pregnancy test before tx start; avoid pregnancy by using effective contraception during and after tx in female pts
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: other; CYP450: unknown
Excretion: unknown; Half-life: unknown
Subclass: Immunotherapy, CAR T-Cells ; Immunotherapy, CD19 Inhibitors
Mechanism of Action
binds to CD19-expressing cells via chimeric antigen receptor (CAR)-positive autologous T-cells, inducing T-cell expansion, activation, and proliferation, and eliminating CD19-expressing cells
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.